Premature menopause may result in heart disease

• Menopause before the age of 40 is known as premature menopause
• Premature menopause speeds up age-related changes in certain blood cells
• These early changes in blood cells increase the risk for heart disease

Menopause that occurs before the age of 40 – known as premature menopause – has been identified by researchers as a risk factor for cardiovascular disease.

This discovery was made by researchers at Massachusetts General Hospital (MGH), and the findings reveal that certain age-related changes in blood cells may be associated with cardiovascular disease.

Dr Pradeep Natarajan, senior author of the study and investigator of  Preventative Cardiology at MGH, explains: “We recently found that the presence of chronological-age-associated mutations in blood cells – called clonal haematopoiesis – without overt cancer is a new risk factor for coronary artery disease.”

What is clonal haematopoiesis? 

According to the American Association for the Advancement of Science (AAAS), “Clonal haematopoiesis is characterised by the overrepresentation of blood cells derived from a single clone.” 

Previously, it was thought that only blood cancers were examples of clonal haematopoiesis, but in the 1990s it was found that it also occurs in persons without cancer.

Links between premature menopause and coronary artery disease

Dr Natarajan expressed that the team were curious as to whether earlier menopause was linked to clonal haematopoiesis, which led them to conduct a study.

The study involved the analysis of blood samples of post-menopausal women – 11495 samples were from the UK Biobank (aged 40–70) years, and 8111 were from the Women’s Health Initiative (WHI) (aged 50–79) years. With an average follow up of 10 and 13.1 years, there were 473 (UK Biobank) and 1146 (WHI) new cases of coronary artery disease.

DNA sequencing of blood cells was used to identify the occurrence of clonal haematopoiesis. Premature menopause was linked to higher levels of clonal haematopoiesis, and clonal haematopoiesis increases the risk of developing coronary artery disease by 36%. The results of this study allow for preventative measures to be taken by women undergoing premature menopause.

Dr Natarajan expressed that “screening [for clonal haematopoiesis] may facilitate novel precision medicine strategies for coronary artery disease in affected women".

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